Concomitant Chemoradiotherapy Using Carboplatin and Etoposide-induced Cutaneous Vasculitis in a Patient with Small Cell Lung Cancer.

Drug-induced vasculitis occurs after drug exposure and consequent inflammation of small blood vessels which can lead to damage of affected tissue. Rare cases of drug-induced vasculitis during chemotherapy or concomitant chemoradiotherapy have been described in the literature. Our patient was diagnosed with stage IIIA (cT4N1M0) small cell lung cancer (SCLC). Four weeks after the application of the second cycle carboplatin and etoposide (CE) chemotherapy, the patient developed cutaneous vasculitis and rash on the lower extremities. CE chemotherapy was discontinued and symptomatic therapy with methylprednisolone was administered. On prescribed corticosteroid therapy, there was an improvement in local finding. After completion of chemoradiotherapy, the patient continued treatment with four cycles of consolidation chemotherapy with cisplatin (six cycles of chemotherapy in total). Clinical examination verified further regression of the cutaneous vasculitis. Elective radiotherapy of the brain was performed after completion of consolidation chemotherapy treatment. The patient was clinically monitored until disease relapse. Subsequent lines of chemotherapy for platinum-resistant disease were administered. The patient died seventeen months after diagnosis of SCLC. To our knowledge, this is the first described case of a patient who developed vasculitis of lower extremities during concomitant administration of radiotherapy and CE chemotherapy as a part of the primary treatment for SCLC.